Individual
DR. KENNETH THERIOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4002 E MAIN ST STE 1, MESA, AZ 85205-8612
(480) 324-5421
(480) 324-5459
Mailing address
18827 E SWAN DR, QUEEN CREEK, AZ 85142-5314
(480) 275-8886
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2008015177
MO
207L00000X
Anesthesiology Physician
Primary
44415
AZ
Other
Enumeration date
09/21/2008
Last updated
03/29/2012
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